PATIENT FINANCIAL ACCESS (PFAS) REVENUE CYCLE ANALYST (FULL TIME, DAYS)
University of Washington
Location: Seattle, Washington
Type: Full Time
Internal Number: 191902
A higher degree of healthcare.
All across UW Medicine, our employees collaborate to perform the highest quality work with integrity and compassion and to create a respectful, welcoming environment where every patient, family, student and colleague is valued and honored.
UW Medicine’s mission is to improve the health of the public by advancing medical knowledge, providing outstanding primary and specialty care to the people of the region, and preparing tomorrow’s physicians, scientists and other health professionals.
The PATIENT FINANCIAL ACCESS BUSINESS OPERATIONS team has an outstanding opportunity for a PATIENT FINANCIAL ACCESS (PFAS) REVENUE CYCLE ANALYST. The UW Medicine Patient Financial Access Revenue Cycle Analyst is both a subject matter expert and Patient Access systems expert who proactively identifies workflow and system opportunities and assists Revenue Cycle leadership in the coordination of complex projects that promote operational efficiencies and enhance system tools specifically related to insurance. The UW Medicine Patient Access Business Operations Analyst works independently, coordinating and performing identified actions among and between all levels of revenue cycle, contracting, PFS, clinical and financial department staff to resolve complex issues on accounts and patient records which assure an account can be submitted correctly to the payor or make available the ability to document and report clearly.
The UW Medicine Patient Financial Access Revenue Cycle Analyst assists with coordinating the plan, design, documentation, reporting, testing and implementation of quality and auditing for insurance related processes, workflow analysis and recommendation to insurance system enhancements, and specific insurance training development and delivery. The position incumbent must have skills and knowledge that span the entire lifecycle of UW Medicine patient access insurance requirements, from initial business process analysis and requirements gathering, through system stabilization, error resolution, denial reduction, to process analysis and improvement. This role is responsible for working with a diverse group of people from all UW Medicine entities to analyze, identify new features for new plan development and delivery used within Patient Access Systems. Incumbent is responsible for account audits, trend research, report creation, report maintenance, leadership report outs and recommendation related to best practice insurance requirements, collection, data entry and maintenance to ensure approprpriate plancode selection by all revenue cycle staff members. This requires a deep understanding of insurance related operations, systems collection of insurance info, system tools that present insurance related information to UW Medicine staff members. Requires a cross-functional systems knowledge and support skills for applications used in conjunction with Epic functions and by multiple UW Medicine customer groups.
Epic Revenue Cycle Operations is a newly formed unit, post implementation, which supports all of UW Medicine Patient Access, Insurance mainteance and education, Hospital Billing, Finance and other related operations that use Epic functionality. UW Medicine is comprised of UW Medical Center, Harborview Medical Center, Seattle Cancer Care Alliance, UW School of Medicine, and UW Physicians Network. This group is responsible for ongoing education, reporting, metric development and maintenace, and support of the infrastructure of insurance requirements which support these institutions, along with the implementation of new services lines and benefits that are used to support and further the mission of patient care, research and teaching.
The UW Medicine Patient Financial Access Revenue Cycle Analyst is responsible for auditing accounts with a focus on required minimum data collection related to insurance related requirements and issue resolution, insurance data collection quality projects, and insurance related educational development, reporting, maintenance and delivery, requiring a broad knowledge of all aspects insurance and the selection of appropriate insurance in Epic and other related Patient Financial Access systems. The QA Analyst performs analysis of account data entry requirements for appropriate insurance, auditing data collection and usage, system insurance related issues, fixes immediate issues, redesigns workflows and performs testing, and works with operational personnel to match system technical capabilities with the business requirements of apropriate insurance selection for UW Medicine.
The PATIENT FINANCIAL ACCESS (PFAS) REVENUE CYCLE ANALYST will:
Analyze business processes and procedures with a focus on insurance related requirements
Analyze system impact and opportunities for insurance related enhancements
Proactively review and evaluate insurance related system updates and coordinate upgrade implementation, including analysis, design, operations inputs to testing and implementation are successful
Ensure input data are highest quality necessary to produce clean claims and reduce denials created by Patient Access processes.
Define and document customer requirements
Proactively monitor and maintain systems
Perform problem resolution
Develop and maintain QA documentation for insurance related updates, enhancements, training, monthly communication
Identify error patterns and recommend training or revised workflows
Provide regular status reporting
Research and analyze current and proposed business practices and system upgrades and impact related to insurance updates and requirements along the entire revenue cycle
Recommend new process improvements that ensure appropriate plan selection to ensure clean claims, are compliant with payer requirements and governmental regulations, and reduce denials
Evaluate possible vendor solutions and system products that enhance the quality, track data compliance with patient access and claims-related functionality
Observe and interview employees regarding operations and procedures
Act as an expert resource to UW Medicine staff by anticipating and identifying educational, procedural and functional problems associated with the revenue cycle system applications and cross-system interfaces related to insurance selection and insurance requirements and regulatory expectations
Set appropriate expectations of customer requirement fulfillment
Define screens, reports and processes (manual as well as automated)
Provide functional expertise to optimize the design and development of revenue cycle systems
Proactively monitor claim edit errors and other HB Account and Patient WQ contacts related to front end insurance processing for compliance
Assist in resolution of application and process problems
Answer calls and provide information on application use and process issues
Work closely with the UW Medicine IT Services Help Desk to provide efficient and responsive support to end user staff
Provide supportive and positive mechanisms for reporting application and system deficiencies, and facilitate reporting of suggestions for system improvements
Using quality improvement principles, monitor system impact on user and departmental workflows and incorporate results into system enhancements
Act as quality assurance liaison between application system end users, revenue cycle leadership, training resources and system developers
Act as a liaison and/or facilitate communication between end users and IT Services system administrators, other analysts and programmers
Participate in leading work with user groups to provide diagnostic assistance, resolution to questions, and problem direction
Work with all required (intradepartmental & interdepartmental) personnel to define and manage changes to system and/or functional workflows
Perform problem resolution
Identify and report patterns of QA system and revenue cycle business requirements non-compliance
Summarize denial patterns and issues created by front end registration and admission errors
Document proposed data flows
Assist with and document the development of new standard operational procedures
Provide weekly status reports on progress to revenue cycle leadership. Information should be accurate timely, and pertinent
Coordinate team effort to create the plan, and the design and implementation of Epic ADT new version/system upgrades
Manage small to medium projects, as assigned
BA in Healthcare Administration, Business or other related field
At least five (5) years in Patient Access positions as a lead or other similar position where analysis and problem solving skills have been demonstrated
Working knowledge of Epic ADT, Prelude, Cadence/Scheduling, hospital billing systems, and other hardware and software systems related to Patient Financial Access
Equivalent experience can substitute for degree requirements
CONDITIONS OF EMPLOYMENT:
This PFAS Revenue Cycle Analyst position is within the Patient Financial Access Business Operations (PABO) team and may require travel to many locations within UWM Campuses and non-UWM campus locations
Position may also require tele-work agreement
Fast-paced professional office environment
Normal working hours. May also work off hours and weekends
On-Call coverage (7x24), as assigned
Must have personal transportation for quick access to multiple sites, including both medical centers and IT Services
UW Medicine includes Harborview Medical Center, UW Medical Center - Montlake, UW Medical Center - Northwest, Valley Medical Center, UW Neighborhood Clinics, UW Physicians, UW School of Medicine, and Airlift Northwest.
Founded in 1861, the University of Washington is one of the oldest public institutions in the west coast and one of the preeminent research universities in the world. The University of Washington is a multi-campus university comprised of three different campuses: Seattle, Tacoma, and Bothell. The Seattle campus is made up of sixteen schools and colleges that serve students ranging from an undergraduate level to a doctoral level. The university is home to world-class libraries, arts, music, drama, and sports, as well as the highest quality medical care in Washington State and a world-class academic medical center. The teaching and research of the University’s many professional schools provide undergraduate and graduate students the education necessary toward achieving an excellence that will serve the state, the region, and the nation. As part of a large and diverse community, the University of Washington serves more students than any other institution in the Northwest.